A bacterial infection of the lungs caused by nontuberculous mycobacteria (NTM) is called NTM lung disease. People with weakened immune systems, chronic (long-term) lung disorders (such as bronchiectasis) are more likely to develop NTM lung disease. Sometimes, this infection is quite difficult to treat, and it requires a long period of antibiotics.
Generally, these bacteria are found in soil and water around us. Some people may get this bacterium from air droplets. In addition, people with NTM lung disease may also experience life-threatening complications, especially if they leave it untreated.
This condition is increasingly common because it affects more than 86,000 people in the U.S. each year.
Symptoms
Usually, people who develop NTM lung disease experience the following symptoms. Examples include:
- Cough (sometimes with blood)
- Chest pain
- Frequent respiratory illnesses
- Appetite changes
- Low fever
- Fatigue (extreme tiredness)
- Night sweats
- Unusual weight loss
- Swollen lymph nodes
- Wheezing
- Dyspnea (shortness of breath)
If you or a loved one experiences any of the previous symptoms, immediately contact your healthcare provider.
Causes and Risk Factors
In general, there are multiple types of nontuberculous mycobacteria that can cause NTM lung disease. However, people often get infected due to the following types. For example, M. avium complex (MAC), M. kansasii, and M. abscessus bacteria. Check below some ways in which the bacterium enters the lungs:
- Bathing, showering, or drinking contaminated water
- Inhaling mycobacteria from dust or dirt
- Certain medical devices may allow bacteria to enter the lungs (such as an inhalation tube)
While anyone may develop NTM lung disease, some factors can make you more prone to this condition. Check some of them below:
- COPD (chronic obstructive pulmonary disease)
- Bronchiectasis
- Cystic fibrosis
- Lung cancer
- Tuberculosis
- Age – Older adults (over 65 years old) are more likely to develop this condition.
- Weakened immune system that can be caused by HIV infection, cancer, and some medicines (such as immunosuppressants)
- Sex – NTM lung disease frequently affects females with a low BMI (body mass index)
What Happens if NTM Lung Disease is Left Untreated?
Some people with this disease may also experience some complications, especially if they ignore the symptoms or do not get treatment in time. Check some examples below:
- Nodular bronchiectasis – This is a condition that causes airway inflammation, and scarring makes mucus clearance difficult. It may also cause recurrent bronchitis and pneumonia.
- Cavitary disease – This complication causes holes (cavities) in the lung tissue, and over time, it may lead to respiratory failure.
- Chronic cough and hemoptysis – People with these complications often experience persistent cough, increased mucus production, and coughing up blood (hemoptysis).
- Frequent respiratory infections (such as pneumonia)
- Adverse reactions to antibiotics – People who are using these medicines for long periods may experience some side effects. These include nausea, liver problems (such as LFT abnormalities), nerve problems (including peripheral neuropathy), and others.
- Extrapulmonary disease – In such cases, NTM lung disease spreads to lymph nodes, skin, soft tissue, or bones.
- Respiratory failure
This document does not contain a full list of complications. However, you can talk with your physician about measures to reduce the risk or even prevent them.
How to Prevent NTM Lung Disease?
Doctors usually recommend the following tips to reduce the risk of developing NTM lung disease. Examples include:
- Protective equipment when working outdoors or with dirt (such as a mask that filters particles)
- Avoid working with soil (especially potting soil), the use of hot tubs and sprayers, and others
- Regularly wash your hands with soap and warm water
- Stop smoking – If you have problems with smoking cessation, discuss it with your doctor.
- Get treatment for existing health conditions, including cystic fibrosis.
Diagnosis
Physicians often diagnose this condition by trying to grow (culture) NTM bacteria from a sputum sample. This sample is mucus from the lungs. Sometimes, doctors may perform a bronchoscopy that involves a lighted tube with a camera on the end to get a sample of mucus. Moreover, doctors need at least 2 positive cultures to confirm this condition because the presence of this bacterium in the lungs does not mean you have the condition. In rare cases, they may also perform some imaging tests to get more information about your lungs and surrounding tissue. These include chest X-rays, CT (computerized tomography) scans, or MRI (magnetic resonance imaging) scans.
Treatment
Most of the time, NTM lung disease is treated with antibiotics that come in the following forms. These include:
- Pills or liquid you swallow
- IV (intravenous) medicines that doctors give you with a needle in your vein
- A specific liquid that you breathe in as a mist with a nebulizer
- Powder that you breathe in with an inhaler
Sometimes, doctors may recommend a combination of antibiotics to improve the effectiveness of the treatment. Rarely, doctors may use airway clearance techniques or chest physiotherapy to improve the symptoms of this disease.
Frequently Asked Questions
Is NTM lung disease contagious?
In general, this condition is not contagious, but in some cases, it may spread between two people with cystic fibrosis. For more details, discuss it with your doctor.
What is the life expectancy of someone with NTM lung disease?
Usually, the prognosis of this condition depends on several factors. For example, the type of mycobacteria that causes infection, existing health conditions (comorbidities), your response to antibiotics, age, and others. Some people develop NTM lung disease even after a successful treatment with antibiotics.
How serious is NTM?
This is a pulmonary infection that often causes long-term (chronic) and debilitating disease. The most common type of mycobacterium that affects people in the U.S. is M. avium complex (MAC), which accounts for more than 80% of diagnosed cases. Ask your healthcare provider if you have any other questions.
